Incident investigation·August 6, 2025

On August 6, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case management visit to follow up on a visit that was conducted on 7/22/25. LPA met with Interim Executive Director, Kathleen Olson and explained the purpose of the visit. On 7/12/25, the Licensee reported that on 7/9/25, it was alleged that Staff 1 (S1) took an unauthorized video of Resident 1 (R1) on S1's personal phone while R1 was sleeping in only his/her pull ups. It was heard on the video that S1 was laughing at R1 and called R1 a mermaid. In the video it was observed that S1 physically abused R1. On 7/12/25, Staff 2 (S2) reported this incident to management and indicated that S1 showed S2 the video. The facility was made aware of this incident on 7/12/25, however the administrator did not notify LPA of this incident until 7/17/25 via telephone. An SOC341 was not submitted to CCLD until 7/18/25 and an incident report was not submitted to CCLD until 7/21/25. The administrator failed to notify CCLD of the alleged abuse incident for 5 days after being aware of the incident. According to the administrator, there was a delay in reporting due to the incident being a hearsay incident and wanted to conduct an investigation prior to reporting to CCLD. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with the Interim Executive Director and a copy is provided with appeal rights.